Provider Demographics
NPI:1831230929
Name:CONNELL, ALAN BRUCE
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:BRUCE
Last Name:CONNELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 DEER CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-7943
Mailing Address - Country:US
Mailing Address - Phone:205-426-9919
Mailing Address - Fax:205-426-9980
Practice Address - Street 1:815 8TH ST N
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35020-5303
Practice Address - Country:US
Practice Address - Phone:205-426-9919
Practice Address - Fax:205-426-9980
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7431183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist